Extra Help With Medicare Drug Costs: Who Gets It and How to Apply

Use this before you call.

Want to compare drug plans with Extra Help in mind? Call GetFastRates.com and a licensed agent will check your medicines.

Check whether you already get it: people with Medicaid or a Medicare Savings Program generally get Extra Help automatically.

If you do not, apply through Social Security. It is free.

Have your income and resource information ready, and be honest about both.

Keep your Medicare drug plan, or join one: Extra Help works with a drug plan, it does not replace one.

Look at your drug plan's list of covered drugs to make sure your medicines are on it.

Call us if you want to compare drug plans with your Extra Help in mind.

What it does

Extra Help helps with what you pay for a Medicare drug plan, such as the plan's premium and what you pay when you fill a prescription. People who qualify for Medicaid or a Medicare Savings Program (QMB, SLMB or QI) get Extra Help too, and the amount you pay for each covered drug is limited.

Who gets it automatically, and who applies

You generally do not need to apply if you have Medicaid or you are in a Medicare Savings Program. Other people with limited income and resources can apply through Social Security, which decides.

Have both Medicare and Medicaid: Extra Help is automatic.
In QMB, SLMB or QI: Extra Help is included.
Limited income and resources but no Medicaid: apply through Social Security.
The limits change every year, so we do not list numbers here. Social Security can tell you.

What it does not do

Extra Help does not cover drugs your plan does not cover, and it does not pay for care that is not a prescription drug. You still choose a drug plan, and a plan with the drugs you take on its list matters more than ever.

If you pick a plan that does not cover your drug, Extra Help does not fix that.
Check the plan's list of covered drugs and pharmacies every year.

Watch for scams

Applying for Extra Help is free. Anyone who calls you offering Extra Help for a fee, or asks for your Medicare number or bank details to 'qualify' you, is not a government program.

Common questions about this topic

If I have Medicaid, do I need to apply for Extra Help?

Generally no. People with full Medicaid are automatically enrolled in Extra Help. Check your drug plan notices to see.

Does Extra Help lower my Part B premium?

No. Extra Help is for drug costs. The Medicare Savings Programs, run by your state, can help with the Part B premium.

Can I get Extra Help and a Medicare Advantage plan?

Yes. If your Medicare Advantage plan includes drug coverage, Extra Help works with it as well.

Related coverage articles

Do I Qualify for Extra Medicare Benefits? The Programs That Can Really Lower Your CostsExtra Help, Medicare Savings Programs, Medicaid, special plans and the extras some Medicare Advantage plans include: who each is for, who decides, and where to ask. Start with the ones that do not depend on a commercial.Medicare Savings Programs Explained: QMB, SLMB, QI and QDWIMedicare Savings Programs are run by your state and can pay your Medicare premiums and sometimes your deductibles and copayments. Here is what each program does and how to apply.Medicare Part D Prescription Review ChecklistA checklist for reviewing Medicare prescription drug questions, pharmacies, formularies, deductibles, tiers, and medication changes.Check Your Part D Formulary Before Enrolling ChecklistA checklist for confirming your prescriptions are actually covered, and at what cost, before enrolling in a Medicare Part D or Medicare Advantage drug plan.

Tools that can help

Medicare Enrollment Period CalculatorFind your Medicare enrollment window and what it means for your timing.Medicare Part B Late Enrollment Penalty CalculatorEstimate whether a Part B late enrollment penalty could apply to you.Medicare Plan Ending FinderCheck your carrier and ZIP code against current, verified plan-ending records.

Trusted public sources

These links are provided for general public information. They do not replace a personal coverage review.